NN&I - April 2010
Patient Management www.nephronline.comApril 2010 Nephrology News & Issues 25 Table 1. Outcomes stratified by serum ferritin cutoff of 800 vs 1,200 ng/mL Lab value 2007 analysis: Serum ferritin cut-off of 800 ng/mL 2008 analysis: Serum ferritin cutoff of 1200 ng/mL P valueIron, mg/wk 83.9 \261 36.8 51 \261 27.1 .001 ESA, IU/wk 15,935 \261 11,947 13,165 \261 11,933 .19 Hb, g/dL 12.0 \261 .7 11.6 \261 .6 .017 TSAT, % 31.7 \261 12 28.3 \261 6.8 .22 Albumin, g/dL 3.8 \261 .3 3.8 \261 .3 .70 Serum ferritin, ng/mL 856.2 \261 305.7 800.7 \261 260.5 .37 Results A total of 133 patients were screened for this study using electronic records and written chart records located in the two facilities. Data from 49 patients receiving IV iron were reviewed. Of these, 15 patients met the inclusion criteria. The fact that the patients had data over both IV iron administration periods allowed them to serve as their own controls. Of the participants, 50% were men, 33% had diabetes, and all were non-black. The mean age was 55 years. Compared with 2007 data, the 2008 analysis showed a significant reduc -tion in the average weekly IV iron dose in patients given ferric gluconate in a low-dose regimen using a serum ferri-tin cutoff of 1,200 ng/mL (P=.001) (see Table 1). In addition, there was a reduc-tion in ESA requirements in 2008 com-pared with the previous year. Hb and TSAT levels remained within target ranges recommended by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI).1 A small but nonsignificant reduction in serum ferritin levels was observed. The changes in mean weekly IV iron and ESA dose, mean TSAT, and mean Hb are shown in Figure 1. Discussion The primary finding of our study was that IV ferric gluconate adminis - Patient Management_0410_7.indd 25 3/18/10 3:45:33 PM
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